Individual provider Active NPI

Kacie Marie Hamreus, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1154702728
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60675885 Issued in WA
Practice address
315 SE Stonemill Dr Ste 103
Vancouver, WA 98684-6998
Phone
(360) 666-4480
NPI assigned
Jun 9, 2015
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60675885 WA Primary

Addresses

Primary practice location

315 SE Stonemill Dr Ste 103
Vancouver, WA 98684-6998

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

101 NW 12th Ave Ste 107
Battle Ground, WA 98604-9141
Phone (360) 666-4480

Other identifiers 1

IdentifierTypeStateIssuer
500715960MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khamreus529407@oc.providencedirect.org
Direct Messaging Address khamreus529407@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161006001999 WA Practitioner - Physician Assistant 4486942406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

505 NE 87TH Ave
Vancouver, WA 98664-1965

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Feb 25, 2025 Accepting new patients
Peacehealth CurrentSince Dec 30, 2024 Accepting new patients

Locations

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

3101 SE 192nd Ave
Vancouver, WA 98683
Phone (360) 729-8010

315 SE Stonemill Dr
Ste 102
Vancouver, WA 98684
Phone (360) 816-2700

315 SE Stonemill Dr
Ste 103
Vancouver, WA 98684
Phone (360) 666-4480

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

Interoperability endpoints

  • Direct secure messaging: khamreus678290@direct.peacehealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1154702728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SE STONEMILL DR STE 103",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846998",
            "telephone_number": "360-666-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 NW 12th Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Battle Ground",
            "state": "WA",
            "postal_code": "986049141",
            "country_code": "US",
            "telephone_number": "360-666-4480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMREUS",
        "first_name": "KACIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60675885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500715960",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khamreus529407@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "101 NW 12th Ave Ste 107",
            "city": "Battle Ground",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986049141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khamreus529407@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3101 SE 192nd Avenue",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.